It’s one of the most Googled and gut-wrenching phrases:
“Positive pregnancy test but no baby on ultrasound.”
If you’ve just had your first ultrasound and the screen was empty—take a breath. This doesn’t automatically mean the worst. Let’s walk through what it can mean, especially in the 4 to 6 week window.
First: What Should You See on a 5 Week Ultrasound?
At 5 weeks, it’s normal for an ultrasound to show:
- A gestational sac
- Sometimes a yolk sac
- Rarely a fetal pole
- No heartbeat yet — that’s expected
But what if the uterus looks completely empty?
1. It Might Just Be Too Early
Even a few days can make a big difference. If you ovulated later than expected or implanted late, your body might be further behind than the calendar says.
✅ What to do: Repeat your HCG blood levels 48 hours apart. Rising levels are a good sign.
2. Possible Ectopic Pregnancy
An ectopic pregnancy happens when the fertilized egg implants outside the uterus, usually in a fallopian tube. It can cause:
- Sharp pain (usually on one side)
- Spotting or bleeding
- No gestational sac in uterus
Ectopics are rare but serious, so they’re ruled out first if the uterus is empty.
⚠️ Go to the ER if you're in pain or feeling faint.
3. Blighted Ovum (Anembryonic Pregnancy)
This means a gestational sac formed, but no embryo developed. It’s a common cause of early miscarriage.
🕒 Often diagnosed around week 7–8 when no fetal pole or heartbeat is seen.
4. Chemical Pregnancy
In this case, the body starts producing HCG but the pregnancy doesn’t progress. You may have a positive test, but HCG levels start to drop before anything is visible on ultrasound.
👀 Usually resolves naturally with bleeding (like a late period).
5. Wrong Dates — Seriously
We can’t stress this enough. Ovulation isn’t always on day 14. Even IVF dates can be off due to delayed implantation.
Your takeaway? A positive test with no visible baby at 5 weeks isn’t rare. It’s frustrating, but not final.
When Will You Know More?
Your provider may order:
- Repeat HCG blood tests
- A follow-up ultrasound in 5–7 days
In many cases, everything turns out completely normal — it was just too early to see more.
Final Thoughts
Seeing nothing on that screen can feel like the world is collapsing. But trust the process, and remember: 5 weeks is often too early to see a baby. Only time, labs, and follow-ups can give you clarity.
If you’ve been through this, you're not alone. 💛
And if you're still waiting — we’re with you.
Have you experienced this? Share your story in the comments — OneScrappyMom is a space for honesty, support, and zero judgment.